Objective To reduce prevalence of anaemia in low-income postpartum women.Design A randomised, non-blind clinical trial was conducted among 959 low-income, postpartum women in eleven clinics in Mississippi. The clinics were randomised to one of three treatment groups: (i) selective anaemia screening of high-risk women as recommended currently (control); (ii) universal anaemia screening and treatment of anaemic women (group I); and (iii) universal Fe supplementation of 65 mg/d for two months to all low-income women (group II). All study participants within each clinic received the same treatment. Women were followed up at 6 months after delivery. Hb was measured at baseline and at follow-up. The primary outcome variable was the proportion of women with anaemia after treatment.Setting Eleven health clinics in Mississippi.Subjects Low-income, postpartum women.Results Baseline characteristics of the three study groups were compared using one-way ANOVA and an appropriate post hoc test for continuous variables and the χ 2 test for categorical variables. Fifty-two per cent of postpartum women were anaemic (Hb < 12.0 g/dl) and the rate decreased to 33 % at 6 months after the intervention. Group II women, who received universal Fe supplementation, improved their Hb status significantly (P < 0.001) at 6 months postpartum compared with the other groups. Prevalence of anaemia was also significantly lower among group II women (22.5 %) compared with controls (34 %) and group I women (43 %; P < 0.001).Conclusions A universal Fe supplementation strategy was effective in reducing the prevalence of anaemia among low-income postpartum women.

The purpose of this research was to examine psychosocial and body weight correlates of dietary behavior in low-income tri-ethnic women. In Study 1, a semi-quantitative food frequency questionnaire (FFQ) was developed and validated against diet records in 95 college women and 50 low-income postpartum women. Pearson's correlations were 0.42 among college women and 0.45 among low-income women. Cross-classification of participants into quartiles resulted in 76% of college women and 79% of low-income women being classified correctly. These results suggested that the FFQ was valid for dietary assessment among young women in the southwestern United States. In Study 2, approximately 160 mothers were recruited in the hospital 0-1 days following childbirth, and prepregnancy weight and demographic information were obtained. Weight was measured at 6 months and 1 year postpartum; psychosocial factors were assessed at 1 year. Diet during pregnancy and postpartum was assessed via food frequency questionnaires administered at 1.5 months, and at 6 and 12 months postpartum, respectively. From pregnancy to postpartum, % calories from fat (delta = +1.1%, p<0.05) and added sugar (delta = +2.0%, p<0.05) increased. A greater percentage of lactating than non-lactating women (64% vs. 38%, p<0.05) met recommendations for fruits during pregnancy. Mean intakes of calcium, vitamin A and dairy foods were higher in women who had retained <10% of their prepregnancy weight at 1 year postpartum than in those who had gained [greater-than or equal to] 10%. During late postpartum, women in the highest tertile of compliance with dietary recommendations had a more positive body image (p<0.041) than those in the lowest tertile, and less neglect of self-care (p<0.001), weight-related distress (p<0.006), stress (p<0.009), depressive symptoms (p<0.020), and perceived barriers to weight loss (p<0.039). These findings suggest that the transition from pregnancy to postpartum is associated with a negative impact on dietary behavior in low-income women. Intakes of calcium, vitamin A and dairy foods may be associated with lower weight retention in postpartum. Furthermore, psychosocial variables may influence adherence to dietary guidelines during this time. / text

The purpose of this study was to determine the influence of diet and physical activity behaviors on weight status and lipid profiles in low-income women in early postpartum. In addition, the relationship of nutrition knowledge with dietary intakes was evaluated. A convenience sample of low-income mothers was recruited from public health clinics, community centers, and doctor's offices. Inclusion criteria was Hispanic, African American, or Caucasian ethnicity; body mass index (BMI) [greater-than or equal to] 25 kg/m², low-income (annual household income <185% federal poverty line); parity<3 and ability to speak and write English. Demographic, dietary (24-hr recalls and 2 day food intake recalls), psychosocial, anthropometric, serum lipids (LDL, HDL and total cholesterol and triglycerides) and physical activity (pedometer steps) data were collected. For study 1, the Healthy Eating Index-2005 (HEI-2005) scores were computed as a measure of diet quality in a sample of 125 women. Analysis of Covariance and linear regression was performed to determine the relationship between HEI-2005 and serum lipids. The mean total index score of the sample was 51.4 and was associated inversely with BMI ([beta]=-0.117), LDL ([beta]=-.659) and total ([beta]=-.690) and positively with HDL ([beta]=.216) (P<0.05). Less than 20% of the sample failed to meet the recommendations for fruits, total vegetables, whole grains and oil and 60% had overconsumption of solid fats, alcohol and added sugars. In study 2, snacking frequency and choices of 134 postpartum women were evaluated. Influence of snacking frequency on HEI-2005 scores and disparities in snack choices by BMI categories was assessed by performing ANCOVA. A majority of the sample (82%) consumed snacks and the most favored snack group was sweets and desserts. Increase in snacking frequency was associated with higher mean total HEI-2005 scores, and total fruit, dark green vegetables and legumes, total grains, and saturated fat (P<0.05) component scores when adjusted for energy intakes. Snacking frequency was also associated with higher intakes of protein, vitamins A and C, and calcium (P<0.05). In study 3, 66 new mothers participated and completed an 8-week weight loss intervention promoting exercise by using pedometers. Paired t test revealed improvement in physical activity after intervention. Linear regression analysis determined the ability of pedometer steps to predict weight loss ([beta]=0.465), % body fat ([beta]=-0.316), triglycerides ([beta]=-0.549), LDL ([beta]=-0.391) and total cholesterol ([beta]=-0.418). In study 4, a nutrition knowledge scale was developed and validated in new mothers. Knowledge was associated with greater consumption of grains, low fat meats and dairy (P<0.01), fiber (p<0.01), calcium (p<0.001), and iron (p<0.05). Participants appeared to be more cognizant of information about vitamins and minerals and weight management and less of energy nutrients and calorie counting. Hierarchical regression model identified age, education, ethnicity and income as determinants of knowledge. / text

No description available.

Introduction: Postpartum women living with HIV (WLWHIV) on antiretroviral therapy (ART) are at high risk of viraemia. We examined the association between unintended pregnancy and HIV viral load (VL) at 24 months postpartum in Cape Town, South Africa. Methods: Data are from a randomised trial that compared different ART delivery modalities for postpartum women aged at least 18 years who had initiated ART during their most recent pregnancy, had a VL<400 copies/ml in the previous three months, and had no comorbidities necessitating regular clinical follow-up. Pregnancy intentions regarding the most recent pregnancy were self-reported at enrolment into the study. VL was measured at 24 months postpartum, with elevated VL defined as VL≥1000 copies/ml. Chi-squared tests and logistic regression were used to examine predictors of unintended pregnancy. The impact of unintended pregnancy on elevated VL was examined using Poisson regression models. Results: Among 411 women included in the analysis (mean age: 28.7 years, 42% married/cohabiting, 75% with a parity≥2, and 86% with a VL<50 copies/ml), 57% reported that their most recent pregnancy was unintended. Compared to women aged 18-24 years, older women had a lower relative odds of unintended pregnancy [25-28 years, adjusted odds ratio (AOR): 0.34; 95% confidence interval (CI): 0.17-0.70; 29-34 years, AOR: 0.18; CI: 0.08-0.37; and ≥35 years, AOR: 0.35; CI: 0.14-0.89]. Additionally, unintended pregnancy was associated with being unmarried/not cohabiting (AOR: 4.44; CI: 2.78-7.09) and with higher parity (compared to parity=1: parity=2, AOR: 3.47; 95% CI: 1.86-6.50; and parity≥3, AOR: 6.38; 95% CI: 3.06-13.28). VL data at 24 months postpartum were available for 89% (366/411) of participants of whom 24% had elevated VL≥1000 copies/ml. Unintended pregnancy was associated with elevated VL in unadjusted analyses [risk ratio (RR): 1.54; CI: 1.03-2.28; p=0.032]. After adjustment for maternal factors and trial allocation, the association persisted despite not reaching statistical significance (adjusted risk ratio (aRR): 1.36; CI: 0.88-2.08; p=0.158). Conclusion: Among postpartum WLWHIV in South Africa, unintended pregnancy is prevalent and could be a risk factor for elevated VL. Reproductive health counselling and support during routine care visits may reduce unintended pregnancies and its effects.

No description available.

No description available.

Introdução: No período pós-parto, as mulheres vivenciam diversas transições e modificações nos âmbitos físico, emocional, familiar e social, das quais derivam situações latentes, relacionadas às responsabilidades conjugais, familiares e os cuidados com o seu filho. Nesta fase do curso de vida feminino, a educação em saúde representa importante recurso para promover saúde, prevenir intercorrências e minimizar sentimentos de insegurança e ansiedade inerentes ao período pós-parto. Objetivos: Elaborar cartilha educativa para promover o autocuidado da puérpera e os cuidados com o seu filho recém-nascido segundo as demandas expressas por mulheres que vivenciam esta fase da vida. Explorar demandas educacionais das mães no puerpério e do cuidado do recém-nascido; identificar as demandas educacionais de maridos/companheiros relacionadas aos cuidados das mulheres no puerpério e dos recém-nascidos; identificar estratégias de atendimento às demandas de suporte segundo as necessidades expressas por essas mulheres. Metodologia: Pesquisa qualitativa, aplicada por meio da pesquisa participativa no munícipio de Rio Grande (RS), Brasil, com 22 mulheres no período pós-parto imediato e com 9 maridos/companheiros, com dados coletados por entrevistas semiestruturadas. Resultados: Referente aos cuidados da mulher no período pós-parto, foram identificadas as categorias: episiotomia, cesárea, loquiação e involução uterina, edema de membros inferiores, gases, alimentação, higiene, consulta médica de retorno, emoções, adaptações e suporte necessários para o período pós-parto e conhecimentos sobre sexualidade no pós-parto. Referente aos cuidados com o recém-nascido, as categorias foram: aleitamento materno, coto umbilical, higiene, pele, sono, soluço/arroto/refluxo, cólicas e eliminações intestinais e urinárias, vestuário e vacinas. Outra categoria foi a busca de informações na internet sobre autocuidado e cuidado com o recém-nascido. Discussão: O período pós-parto desencadeia alterações corporais e emocionais nas mulheres. O conhecimento de tais alterações influi sobre a forma como a mulher vivencia esta fase da vida. Durante a pesquisa participativa, as mulheres fizeram questionamentos e reflexões que permitiram identificar as demandas para desenvolver o autocuidado e o cuidado com dos filhos. Tais demandas nortearam a composição do material educativo, que foi elaborado com base em evidências científicas atualizadas. Este material foi aprovado por um grupo de peritos, quanto ao seu teor científico, e por algumas mulheres, no que se referiu à facilidade de compreensão da linguagem e das ilustrações. Conclusões: A pesquisa participativa permitiu perceber que as mulheres do estudo têm muitas dúvidas sobre autocuidado e cuidados com o recém-nascido. O título do material educativo produzido (\"Tempo de amor e adaptação: promoção da saúde da mulher no pós-parto e do recém-nascido\") revela que o período pós-parto consiste em uma fase do curso de vida feminino caracterizado pela vivência de sentimentos de amor, mas que a vivência plena deste sentimento demanda o oferecimento de suporte profissional e familiar. A existência deste suporte é fundamental para que as adaptações pessoais e familiares possam ocorrer de forma suave e conforme os anseios das próprias mulheres. / Introduction: In the postpartum period, the women experience several transitions and changes that occur in the physical, emotional, family and social dimensions. These important changes to provoke a latent condition derived from the responsibilities in the marital, family members, and children care scopes. Especially in this stage of female life course, the health education is an important resource to promote health, to prevent complications and to reduce feelings of insecurity and anxiety, which are inherent to the postpartum period. The relevance of this study is justified in this scenario considering its main purpose, to develop an educational support material to promote the womens health and their newborn in the postpartum period. General Objective: To develop an educational support material to promote self-care and postpartum care of their newborn child according to the demands expressed by women who experience this phase of life. Specific Objectives: To explore the educational demands of physical, emotional and social nature of women who experience the experience postpartum and newborn child care; identify the educational demands of husbands/partners related to women\'s care who are postpartum and newborn; to identify strategies for meeting the support needs of physical, emotional and social according to the needs expressed by women who experience postpartum experience and newborn care; draw up an educational material to meet the demand for educational support women who experience postpartum care of the newborn. Methodology: A qualitative research was developed through participatory research. The study setting was the Rio Grande City (RS), Brazil. Twenty-two women living in the immediate postpartum period and nine husbands/partners have participated in this research study. The data were collected through semi-structured interviews done during home visits, and across the three educational workshops with collective participation. All these meetings were integrally audiotaped. These amounts of data were recorded in audio and transcribed in full, and repetitive reading and full of all interviews, coding the interviews by the similarity in the statements of the research subjects and the reflections of the researcher, who prepared themes in order to respond fully to the research question, analyzed this data set. This analysis permitted to elaborate themes to fully answer the research questions. The elaborated themes were used to guide the composition of educational material content. The ethical aspects of research involving humans were being respected according to the recommended in Resolution 466/2012 of the National Health Council, and the research protocol was approved by the Ethics Committee of the USP School of Nursing (register number 1,212,765) and University hospital of the Federal University of Rio Grande, RS (register number 167/2015). Results: The themes related to the womens care in the postpartum period were related to episiotomy, cesarean section, loquiation and uterine involution, lower limb edema, gas, food, hygiene, medical consultation return, emotions, adaptations and support needs related to postpartums experiences and the sexuality across the postpartum period. In relation to the newborn care, the themes requested by the women were related to breastfeeding, umbilical stump care, hygiene, skin care, sleep, sob/burp /reflux, colic, intestinal/urinary elimination, clothing and vaccines. Another theme was related to the search for information on the web about self-care and newborn care. Discussion: The postpartum period triggers bodily and emotional changes in women and knowledge of such changes influence on how women experience this phase of life course. During the PP process, women have expressed questions and did reflections about the self-care needs, and their childrens care. Such demands have guided the composition of educational material, which was based on updated scientific evidence. This material has been approved by an expert group as to their scientific content and for some women, as referred to the ease of understanding of language and illustrations. Conclusions: Through the PP, it was revealed that women who were in the immediate postpartum period have many doubts related to self-care and the newborns care. The produced educational material was titled \"Time of love and adaptation: promotion of women\'s health in the postpartum and newborn.\" This title reveals that the postpartum period is a phase of the female life course characterized by the experience of feelings of love, but it is a period of the womens life course demanding professional and family members support. The availability of this support according to the womens own needs and desires is essential for a smooth family and personal adjustment in this important stage of their life course.

Introdução: No período pós-parto, as mulheres vivenciam diversas transições e modificações nos âmbitos físico, emocional, familiar e social, das quais derivam situações latentes, relacionadas às responsabilidades conjugais, familiares e os cuidados com o seu filho. Nesta fase do curso de vida feminino, a educação em saúde representa importante recurso para promover saúde, prevenir intercorrências e minimizar sentimentos de insegurança e ansiedade inerentes ao período pós-parto. Objetivos: Elaborar cartilha educativa para promover o autocuidado da puérpera e os cuidados com o seu filho recém-nascido segundo as demandas expressas por mulheres que vivenciam esta fase da vida. Explorar demandas educacionais das mães no puerpério e do cuidado do recém-nascido; identificar as demandas educacionais de maridos/companheiros relacionadas aos cuidados das mulheres no puerpério e dos recém-nascidos; identificar estratégias de atendimento às demandas de suporte segundo as necessidades expressas por essas mulheres. Metodologia: Pesquisa qualitativa, aplicada por meio da pesquisa participativa no munícipio de Rio Grande (RS), Brasil, com 22 mulheres no período pós-parto imediato e com 9 maridos/companheiros, com dados coletados por entrevistas semiestruturadas. Resultados: Referente aos cuidados da mulher no período pós-parto, foram identificadas as categorias: episiotomia, cesárea, loquiação e involução uterina, edema de membros inferiores, gases, alimentação, higiene, consulta médica de retorno, emoções, adaptações e suporte necessários para o período pós-parto e conhecimentos sobre sexualidade no pós-parto. Referente aos cuidados com o recém-nascido, as categorias foram: aleitamento materno, coto umbilical, higiene, pele, sono, soluço/arroto/refluxo, cólicas e eliminações intestinais e urinárias, vestuário e vacinas. Outra categoria foi a busca de informações na internet sobre autocuidado e cuidado com o recém-nascido. Discussão: O período pós-parto desencadeia alterações corporais e emocionais nas mulheres. O conhecimento de tais alterações influi sobre a forma como a mulher vivencia esta fase da vida. Durante a pesquisa participativa, as mulheres fizeram questionamentos e reflexões que permitiram identificar as demandas para desenvolver o autocuidado e o cuidado com dos filhos. Tais demandas nortearam a composição do material educativo, que foi elaborado com base em evidências científicas atualizadas. Este material foi aprovado por um grupo de peritos, quanto ao seu teor científico, e por algumas mulheres, no que se referiu à facilidade de compreensão da linguagem e das ilustrações. Conclusões: A pesquisa participativa permitiu perceber que as mulheres do estudo têm muitas dúvidas sobre autocuidado e cuidados com o recém-nascido. O título do material educativo produzido (\"Tempo de amor e adaptação: promoção da saúde da mulher no pós-parto e do recém-nascido\") revela que o período pós-parto consiste em uma fase do curso de vida feminino caracterizado pela vivência de sentimentos de amor, mas que a vivência plena deste sentimento demanda o oferecimento de suporte profissional e familiar. A existência deste suporte é fundamental para que as adaptações pessoais e familiares possam ocorrer de forma suave e conforme os anseios das próprias mulheres. / Introduction: In the postpartum period, the women experience several transitions and changes that occur in the physical, emotional, family and social dimensions. These important changes to provoke a latent condition derived from the responsibilities in the marital, family members, and children care scopes. Especially in this stage of female life course, the health education is an important resource to promote health, to prevent complications and to reduce feelings of insecurity and anxiety, which are inherent to the postpartum period. The relevance of this study is justified in this scenario considering its main purpose, to develop an educational support material to promote the womens health and their newborn in the postpartum period. General Objective: To develop an educational support material to promote self-care and postpartum care of their newborn child according to the demands expressed by women who experience this phase of life. Specific Objectives: To explore the educational demands of physical, emotional and social nature of women who experience the experience postpartum and newborn child care; identify the educational demands of husbands/partners related to women\'s care who are postpartum and newborn; to identify strategies for meeting the support needs of physical, emotional and social according to the needs expressed by women who experience postpartum experience and newborn care; draw up an educational material to meet the demand for educational support women who experience postpartum care of the newborn. Methodology: A qualitative research was developed through participatory research. The study setting was the Rio Grande City (RS), Brazil. Twenty-two women living in the immediate postpartum period and nine husbands/partners have participated in this research study. The data were collected through semi-structured interviews done during home visits, and across the three educational workshops with collective participation. All these meetings were integrally audiotaped. These amounts of data were recorded in audio and transcribed in full, and repetitive reading and full of all interviews, coding the interviews by the similarity in the statements of the research subjects and the reflections of the researcher, who prepared themes in order to respond fully to the research question, analyzed this data set. This analysis permitted to elaborate themes to fully answer the research questions. The elaborated themes were used to guide the composition of educational material content. The ethical aspects of research involving humans were being respected according to the recommended in Resolution 466/2012 of the National Health Council, and the research protocol was approved by the Ethics Committee of the USP School of Nursing (register number 1,212,765) and University hospital of the Federal University of Rio Grande, RS (register number 167/2015). Results: The themes related to the womens care in the postpartum period were related to episiotomy, cesarean section, loquiation and uterine involution, lower limb edema, gas, food, hygiene, medical consultation return, emotions, adaptations and support needs related to postpartums experiences and the sexuality across the postpartum period. In relation to the newborn care, the themes requested by the women were related to breastfeeding, umbilical stump care, hygiene, skin care, sleep, sob/burp /reflux, colic, intestinal/urinary elimination, clothing and vaccines. Another theme was related to the search for information on the web about self-care and newborn care. Discussion: The postpartum period triggers bodily and emotional changes in women and knowledge of such changes influence on how women experience this phase of life course. During the PP process, women have expressed questions and did reflections about the self-care needs, and their childrens care. Such demands have guided the composition of educational material, which was based on updated scientific evidence. This material has been approved by an expert group as to their scientific content and for some women, as referred to the ease of understanding of language and illustrations. Conclusions: Through the PP, it was revealed that women who were in the immediate postpartum period have many doubts related to self-care and the newborns care. The produced educational material was titled \"Time of love and adaptation: promotion of women\'s health in the postpartum and newborn.\" This title reveals that the postpartum period is a phase of the female life course characterized by the experience of feelings of love, but it is a period of the womens life course demanding professional and family members support. The availability of this support according to the womens own needs and desires is essential for a smooth family and personal adjustment in this important stage of their life course.